Rituximab-Induced Hypogammaglobulinemia and Infections in AQP4 and MOG Antibody–Associated Diseases
| Autor: | Sarah Demortiere, Jean Pelletier, Romain Marignier, Alexandre Avouac, Bertrand Audoin, Audrey Rico, Clemence Boutiere, Adil Maarouf, Jan-Patrick Stellmann |
|---|---|
| Přispěvatelé: | Centre d'Exploration Métabolique par Résonance Magnétique [Marseille] (CEMEREM), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - APHM] (CEMEREM), Hôpital de la Timone [CHU - APHM] (TIMONE)-Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Urinary system [SDV]Life Sciences [q-bio] Infections Gastroenterology Immunoglobulin G Article Myelin oligodendrocyte glycoprotein Hypogammaglobulinemia 03 medical and health sciences 0302 clinical medicine Maintenance therapy Agammaglobulinemia Central Nervous System Diseases Internal medicine medicine Humans 030212 general & internal medicine Prospective Studies Aged Autoantibodies Aged 80 and over Aquaporin 4 biology Respiratory tract infections business.industry Brain [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy Middle Aged medicine.disease 3. Good health Neurology biology.protein Rituximab Female Myelin-Oligodendrocyte Glycoprotein Neurology (clinical) Antibody business 030217 neurology & neurosurgery [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology medicine.drug |
| Zdroj: | Neurology-Neuroimmunology Neuroinflammation Neurology-Neuroimmunology Neuroinflammation, 2021, 8, ⟨10.1212/nxi.0000000000000977⟩ Neurology® Neuroimmunology & Neuroinflammation article-version (Version of Record) 3 |
| Popis: | ObjectiveTo determine the potential association between infections and rituximab (RTX)-induced hypogammaglobulinemia among patients with CNS inflammatory diseases.MethodsWe included in a prospective observational study all consecutive adults with aquaporin 4 (AQP4) or myelin oligodendrocyte glycoprotein (MOG) antibody–positive disorders treated with RTX. Dosing schedule was adapted to memory B-cell measurement.ResultsWe included 48 patients (mean age 47 [SD: 14] years; 77% females; 31 AQP4 positive and 17 MOG positive). The median follow-up was 3.6 years (range: 0.9–8.1 years). The median number of RTX infusions was 8 (range: 2–14). The median dosing interval was 6 months (range: 1.7–13.7 months). Sixty-seven symptomatic infections (SIs) were observed in 26 of 48 (54%) patients, including 13 severe infections in 9 (19%). Urinary and lower respiratory tract infections were the most frequent, representing 42% and 21% of SI. At RTX onset, the immunoglobulin G (IgG) level was abnormal in 3 of 48 (6%) patients. After RTX, 15 (31%), 11 (23%), 3 (6%), and 0 of 48 patients showed sustained IgG level p < 0.001), the dosing intervals (HR = 0.98, 95% CI 0.97–0.99, p < 0.001), and the interaction between IgG level and urinary tract dysfunction (HR = 0.67, 95% CI 0.53–0.85, p < 0.005). IgG level p < 0.01) and previous immunosuppression (HR = 3.4, 95% CI 1.2–10, p < 0.05).ConclusionsRTX used as maintenance therapy in CNS inflammatory diseases is frequently associated with reduced IgG level and increases the infection risk of the most vulnerable patients. |
| Databáze: | OpenAIRE |
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